Abstract During a national measles outbreak in 2018-2019, the Tel Aviv District suffered a major upsurge of cases, with 413 patients reported. Among them, 100 (24%) were under the age of one, 92 (22%) patients were aged 12 months to 4 years, 47 (11%) were 5-18 years, 169 (41%) were aged 19-60 years, 5 (1%) patients were older than 61 years (born before 1957). Among all cases, 230 (56%) were part of the Ultra-Orthodox Jewish community, 55 (13%) were among undocumented African immigrants. Despite high vaccination coverage, sustained measles transmission occurred, owing in part to importations and numerous exposures in medical settings by a susceptible birth cohort. The Ultra-Orthodox Jewish community was particularly afflicted owing to its condense population, high birth rates and multiple exposures in crowded religious settings. This outbreak demonstrates the necessity of addressing immunity gaps as well optimal healthcare planning in order to prevent future outbreaks.

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AbstrackObjectivesIsrael has absorbed > 60,000 migrant from the horn of Africa (MHOA) since 2006. No cross-transmission of Mycobacterium tuberculosis from MOHA to Israeli citizens has yet been reported. This study describes the results of contact investigation and laboratory work-out of a unique mixed cluster which included both MOHA and Israeli citizens.MethodsDescription of the results of epidemiological investigation including laboratory confirmation.ResultsThis unique Mycobacterium tuberculosis strain included 29 patients: 26 were MOHA and three citizens who immigrated to Israel from the former Soviet Union. This is the first mixed cluster described in Israel, which has not been represented in the SITVIT international database of genotyping markers. The transmission from non-citizens to citizens occurred in a nursing institution, when MOHA infected three other contacts- two of whom were retarded residents, one of them died. The index case was screened before employment, and was permitted to return to wok although his chest X-ray demonstrated radiological findings compatible with tuberculosis. Epidemiological links were found in other 12 MOHA members of the cluster.ConclusionThis report describes cross-transmission of Mycobacterium tuberculosis from non-citizens MOHA to Israeli citizens who were residents of a nursing home, which may be the first sign for an epidemiological shift. Although cross-ethnical transmission is still rare in Israel, medical settings should employ efficient infection control measures to protect both patients and staff from Mycobacterium tuberculosis.

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Children treated by chronic RRT have a higher incidence of cancer than their peers, and therefore should be followed closely.